Remote Health Insurance Support Specialist

WPS Health Solutions; Jacksonville (FL); Remote; USD 23,000 - 33,000; Full time

Benefits offered by this job

Remote work options

Performance bonus

401(k) matching

Paid time off

Health insurance

Job summary

WPS Health Solutions is seeking a Customer Care Center Representative to deliver compassionate, accurate responses to members, brokers, and providers. You will research benefits, eligibility, and claims questions across multiple systems, ensuring clear communication.

The role starts January 12 with a training period, and offers a starting base salary of $20.50 per hour. Remote work options are available for qualified states, with regular hours CT time.

Qualifications

• High School Diploma or GED or equivalent experience.
• 1+ year of customer service in health insurance or healthcare call center.
• Strong verbal and written communication with ability to explain complex information.
• Demonstrated problem-solving skills with empathy and patience.
• Proficiency in Microsoft Office Suite and portal navigation.
• Adhere to a structured work schedule based around Central Time.

Responsibilities

• Serve as the first point of contact for members, brokers, and providers with inquiries on benefits, eligibility, claims, billing and services.
• Assist members in understanding benefits, eligibility, claim status and billing issue resolutions.
• Respond to provider inquiries related to claims, authorizations, and reimbursement status.
• Address and resolve service requests, complaints and issues with high customer satisfaction.
• Collaborate with internal teams to handle complex inquiries and ensure a seamless experience.
• Document interactions thoroughly in the system for follow-up and QA.
• Develop understanding of health plan products and stay updated on policies and regulations.
• Ensure adherence to HIPAA, CMS and other regulatory guidelines when providing information.

Skills

Customer service

Communication

Multitasking

Detail-oriented

Problem solving

Microsoft Office

Time management

Education

High School Diploma or GED

Tools

Facets

NTT

Job description

WPS Health Solutions is seeking a Customer Care Center Representative to deliver compassionate, accurate responses to members, brokers, and providers. You will research benefits, eligibility, and claims questions across multiple systems, ensuring clear communication.

The role starts January 12 with a training period, and offers a starting base salary of $20.50 per hour. Remote work options are available for qualified states, with regular hours CT time.